Minnesota retained its number one spot on the United Health Foundation’s America’s Health Rankings. A December 6 StarTribune article summarizes some of the findings and contains some interesting quotes. I also dug deeper and found some interesting material in the rankings report.

From the StarTribune article:

Minnesota is still the healthiest state in the nation, so why are health officials worried? We smoke too much and we’re getting fat. One in five Minnesotans still puffs away and nearly 24 percent are obese, according to the United Health Foundation annual survey released Tuesday. The fat epidemic has hit everywhere, but Minnesotans are gaining weight at a faster clip than the rest of the nation — a 132 percent rise in the obesity rate since 1990 compared with 110 percent nationwide. “We want to celebrate our success, but it would be very easy to become complacent,” said Dianne Mandernach, state health commissioner. “When we look at our obesity rate, that’s not good.”

Dr. Reed Tuckson, senior vice president of the Minnetonka-based foundation, which has been conducting the survey since 1990, said Minnesota is entitled to some bragging rights. The state has taken the top spot four years running and in 17 years has never fallen below second place.

Among its achievements:

Minnesota has the nation’s lowest rate of uninsured (7.4 percent), the lowest rate of cardiovascular death and the fewest years lost because of premature deaths.

Workers in Minnesota are among the safest in the country, and Minnesota babies are less likely to die in infancy than those in just about every other state.

Still, said Tuckson, “we’ve got a lot of work to do.”…

On the trails

A handful of healthy Minnesotans, jogging, biking and walking on a biting, blustery Tuesday, weren’t especially surprised to hear about the state’s stellar health ranking.

And to a person, they said state and local governments should mostly keep doing what they have been to encourage healthful habits.

Lynn and Matt Morgan, restaurant workers from Minneapolis, were walking their puppy, Frances, on the Stone Arch Bridge.

“It’s like they already do a lot to keep us healthier, the bike trails, the dog parks, all the nice public facilities we have to use,” Lynn Morgan said. “They should keep promoting ways for you to be healthy, instead of trying to regulate it.”…

Added Matt Morgan: “I already like to commute by bike, but maybe they could offer a tax write-off to encourage more people to do it.”…

[B]ecause of climbing obesity rates, Mandernach said, she also is looking at a “Just Turn It Off” campaign that would urge Minnesotans to turn off their televisions and computers. Why? Research shows that the longer the tube is on, the more viewers munch, she said.

‘Mature civilization’ or nanny state?

The foundation’s Tuckson said obesity is particularly worrisome because it is a key predictor for future health problems, such as diabetes and other chronic disease.

In 1990, he said, 90 percent of Minnesotans were close to normal weight in the survey, a figure that has fallen to around 76 percent this year.

That tracks with what’s going on in the rest of a country where cars and remote controls have made movement an option and where food is entertainment instead of just sustenance. But it makes for a big problem.

I like the tax write-off idea for bike commuters, though I’m not sure how you’d implement that. It’s probably better to tax fuel more, though that’s difficult to achieve politically.

The “Just Turn It Off” idea is fine, but how about a campaign to get more people out walking and biking? Should we call it “Just Leave the Car Behind”? “Just Ditch the Car”?

The 132 percent rise in obesity in Minnesota since 1990 doesn’t surprise me. It’s not just the availability of high-calorie food that causes this. It’s also the assumption that travel requires an automobile or truck. I understand that some people have little choice but to drive, but I’m still struck by how few people walk or bike to get around, and how people hop in their cars without thinking about the health or environmental implications of doing so.

Digging Deeper

I dug a little deeper into America’s Health Rankings 2006 report. I found that two of its “Seven Tips that Work” for communities relate to inactivity:

Physical Activity – Only 45% of adults and 27% of high school students exercise 30 minutes a day even though this level of activity is proven to reduce many health risks. To improve health, communities can:

• Enhance In-School Physical Education by adding new PE classes, lengthening existing classes and increasing physical activity levels.

• Increase Access to Places for Physical Activity by creating safe walking and biking paths and providing convenient and affordable access to exercise equipment.

The foreword to the report notes that not all is well regarding health in the United States:

To our dismay, this year’s report once again documents the lack of significant progress in improving health status, a trend we first noticed in 2000. And, alarmingly, overall health in the United States continues to suffer in comparison to that of many other nations. For example, a baby girl born today in the United States has a healthy life expectancy of 71 years compared to 78 years for a baby girl born today in Japan!

For more on this issue, see an article in the report, “Improving America’s Health: Personal and Public Solutions,” by Thomas C. Ricketts. Here’s one remarkable paragraph that shows how the nation’s problem with obesity could loom very large indeed:

There is a debate among demographers over whether we will see an extension of lifespan or whether changes in lifestyle that have increased the obesity rate, will cause Americans to experience a decline in life expectancy. The argument that lifespan will increase progressively with many more people reaching the age of 100 or more was posited by two demographers, James Vaupel of Max Planck Institute for Demographic Research of Rostock, Germany and Jim Oeppen of Cambridge University writing in the journal Science. The reaction to that was an immediate concern over the future of pension and retirement funds and how medical care would need to be structured to cope with far more very old people. Countering that prediction, Jay Olshansky and his colleagues predicted that rising rates of obesity would create a decline in life expectancy in the United States[9]. The costs associated with that increase in morbidity would outstrip the current $100 billion spent annually to cope with the consequences of severe overweight including diabetes, renal disease, blindness, amputation and cardiovascular disease. The authors say that ,“The U.S. population may be inadvertently saving Social Security by becoming more obese”, but the larger costs to productivity that ripple through the economy will likely overwhelm that perverse benefit.

One interesting table, titled “Actual Causes of Death,” on the same web page as Mr. Ricketts’ article (page 118 of the report), lists “Poor diet and physical inactivity” as the second leading cause of death (16.6 percent of all deaths), behind tobacco at number 1 (at 18.1 percent). Number 3 is alcohol at a much lower rate of 3.5 percent.

See also, “We Can Take Action Toward Better Health for All Americans Now,” by John M. Clymer, of the Partnership for Prevention, who writes:

America’s overall health improvement has slowed, and the annual rate of improvement has become smaller in recent years. While there are many reasons our progress is stalling, two are most prominent. After several years of reductions in the rate of smoking, the rate of smoking has leveled off, and the epidemic of obesity, especially among children, is dramatically increasing. There is reason for alarm, for today’s smokers will be tomorrow’s patients, and today’s obese youth will be tomorrow’s chronically ill adults, hobbled by arthritis, cancer, diabetes and heart disease….

We should act because poor nutrition and physical inactivity are fueling an epidemic of obesity that is driving diabetes rates up and the age of diabetes onset down. The rise of obesity is offsetting gains that medicine and public health have made against other causes of cancer and heart disease. For the first time in our nation’s history, today’s generation of children may have poorer health than their parents, a decline caused by obesity. Again, we know how to do better.

This entry was posted on Wednesday, December 13th, 2006 at 1:46 pm and is filed under Biking/Walking, Minnesota, Urban Design.